I use a Water-Pik after flossing (and so should you!), and I’ve noticed repeatedly that when I am squirting water between my teeth, I develop a sudden urge to urinate. Then I remembered the old summer-camp trick of putting a sleeping boy’s hands into a bowl of water, which supposedly made him wet his bed. I think asked a few friends if they also had an urge to micturate when they heard running water, and to a person they said “yes.” (One emphasized the need to pee in the shower.)
Well, immediately this brings up a question: “why does this happen?” There are two ways to approach this question.
First, there’s the physiological or “proximal” approach, which asks, “What is the neuronal/physiological basis of having to pee when you hear running water?” This question is in principle answerable, and, as you’ll see, appears to have been answered.
But there’s the evolutionary or “ultimate” approach. If one assumes this connection between water and urination arose directly via natural selection (and remember, it could be fortuitous: simply a byproduct of how our bodies evolved), why is it adaptive to respond to the sound of running water this way?
This question may not be answerable, as we weren’t around to see when it happens. (One could I suppose, at least see if the connection exists in other primates, which would bnttress the fact that it arose in a common ancestor and has persisted, but doesn’t answer whether the connection evolved directly by natural selection.)
These are two different ways of thinking about the question: the “how” approach versus the “why” approach. As I said, the “how” appears to have an answer in humans, as evidenced in this article from Australia’s Swinburn University (click to read):
First of all, the article asserts that the urge to pee when you hear running water is widespread, and occurs not just in the presence of water. (I haven’t had “nervous wees” before a date, though.)
We all know that feeling when nature calls – but what’s far less understood is the psychology behind it. Why, for example, do we get the urge to pee just before getting into the shower, or when we’re swimming? What brings on those “nervous wees” right before a date?
But let’s take a readers’ poll to see how widespread it is. Remember, your answer is anonymous, so please answer:
Now, the “how” answer as given in the article above:
Research suggests our brain and bladder are in constant communication with each other via a neural network called the brain-bladder axis.
This complex web of circuitry is comprised of sensory neural activity, including the sympathetic and parasympathetic nervous systems. These neural connections allow information to be sent back and forth between the brain and bladder.
The brain-bladder axis not only facilitates the act of peeing, but is also responsible for telling us we need to go in the first place.
How do we know when we need to go?
As the bladder fills with urine and expands, this activates special receptors detecting stretch in the nerve-rich lining of the bladder wall. This information is then relayed to the “periaqueductal gray” – a part of the brain in the brainstem which constantly monitors the bladder’s filling status.
Once the bladder reaches a certain threshold (roughly 250-300ml of urine), another part of the brain called the “pontine micturition centre” is activated and signals that the bladder needs to be emptied. We, in turn, register this as that all-too-familiar feeling of fullness and pressure down below.
Beyond this, however, a range of situations can trigger or exacerbate our need to pee, by increasing the production of urine and/or stimulating reflexes in the bladder.
An illustration of where the brain’s “bladder control center”:

There’s more:
Peeing in the shower:
If you’ve ever felt the need to pee while in the shower (no judgement here) it may be due to the sight and sound of running water.
In a 2015 study, researchers demonstrated that males with urinary difficulties found it easier to initiate peeing when listening to the sound of running water being played on a smartphone.
Symptoms of overactive bladder, including urgency (a sudden need to pee), have also been linked to a range of environmental cues involving running water, including washing your hands and taking a shower.
This is likely due to both physiology and psychology. Firstly, the sound of running water may have a relaxing physiological effect, increasing activity of the parasympathetic nervous system. This would relax the bladder muscles and prepare the bladder for emptying.
At the same time, the sound of running water may also have a conditioned psychological effect. Due to the countless times in our lives where this sound has coincided with the actual act of peeing, it may trigger an instinctive reaction in us to urinate.
This would happen in the same way Pavlov’s dog learnt, through repeated pairing, to salivate when a bell was rung.
I’m not sure that a physiological effect differs from a psychological effect, except that the latter would be “learned” rather than inborn. But remember that any physiological effect like this has to come in through the senses and brain, which could be seen as “psychological”.
More “how” answers, involving different mechanisms:
But it’s not just the sight or sound of running water that makes us want to pee. Immersion in cold water has been shown to cause a “cold shock response”, which activates the sympathetic nervous system.
This so-called “fight or flight” response drives up our blood pressure which, in turn, causes our kidneys to filter out more fluid from the bloodstream to stabilise our blood pressure, in a process called “immersion diuresis”. When this happens, our bladder fills up faster than normal, triggering the urge to pee.
Interestingly, immersion in very warm water (such as a relaxing bath) may also increase urine production. In this case, however, it’s due to activation of the parasympathetic nervous system. One study demonstrated an increase in water temperature from 40℃ to 50℃ reduced the time it took for participants to start urinating.
or:
But it’s not just the sight or sound of running water that makes us want to pee. Immersion in cold water has been shown to cause a “cold shock response”, which activates the sympathetic nervous system.
This so-called “fight or flight” response drives up our blood pressure which, in turn, causes our kidneys to filter out more fluid from the bloodstream to stabilise our blood pressure, in a process called “immersion diuresis”. When this happens, our bladder fills up faster than normal, triggering the urge to pee.
Interestingly, immersion in very warm water (such as a relaxing bath) may also increase urine production. In this case, however, it’s due to activation of the parasympathetic nervous system. One study demonstrated an increase in water temperature from 40℃ to 50℃ reduced the time it took for participants to start urinating.
Conclusions:
We all pee (most of us several times a day). Yet research has shown about 75% of adults know little about how this process actually works – and even less about the brain-bladdder axis and its role in urination.
Well, you know now! More:
Most Australians will experience urinary difficulties at some point in their lives, so if you ever have concerns about your urinary health, it’s extremely important to consult a healthcare professional.
And should you ever find yourself unable to pee, perhaps the sight or sound of running water, a relaxing bath or a nice swim will help with getting that stream to flow.
This article was originally published on The Conversation.
The mechanistic explanation also predicts that if you’re in a restroom and you hear other people peeing, that would increase your urge to join them.
As I said, the water-urination response may not be a direct response to natural selection. That is, there may be no reproductive advantage to having to pee when you encounter water. It could simply be, as Gould and Lewontin called it, a “spandrel.” But let’s engage in some “adaptive storytelling” here and think up ways the connection might have been adaptive.
There don’t seem to be many. The first one that struck me was that, as noted above, a lot of people have bladder issues (only ones that occur before reproduction ceases can be considered). If this is the case, and if retaining urine is bad for you. which it is, then anything that facilitates peeing when you have bladder issues would be adaptive. If you already have a physiological system in place for peeing when your bladder’s full, it might be easier to hijack this system in those with bladder issues by using the same stimulus: the sound of running fluid. (This presumes that the sound stimulates urination even in people without bladder issues, which is apparently does.) But somehow I’m not satisfied with this
I asked a colleague, who gave a response that sounded good at the time but now seems dubious as well. He said that if you hear running water, you have an opportunity to hydrate yourself by drinking, and running water is more likely to be clean water that is good to drink. But the connection between having to drink and having to pee is obscure to me.
A question, then, for readers:
So, if one assumes that the connection between water and urination is the result of natural selection, please tender your own theory. Even crazy theories should be given, because, after all, “evolution is cleverer than you are.”
Remember this old joke?











